DIABETES is rarely just about blood sugar levels. For many, it also quietly damages the heart and these two conditions are now rising side by side. The figures are stark: over 101 million Indians live with diabetes and another 136 million are pre-diabetic.
What is coronary artery disease?
Coronary Artery Disease (CAD) occurs when the arteries that supply blood and oxygen to the heart become narrow or blocked due to the buildup of fatty deposits, known as plaque. This blockage reduces blood flow and can result in chest pain, heart attacks, heart failure or even sudden cardiac death. CAD is among the leading causes of illness and death among people with diabetes. The damage, however, is slow and easy to miss.
Factors leading to CAD
A host of conditions or lifestyle choices can cause CAD. Some of the common factors include: high cholesterol levels, history of high blood pressure, obesity, low physical activity, unhealthy diet, family history of cardiac illness, stress, ageing and diabetes.
Why is CAD more challenging for diabetics?
CAD is more challenging and complicated to diagnose in diabetic patients. Over time, high blood sugar damages the blood vessels and nerves carrying pain signals from the heart to the brain. As a result, diabetic patients may not experience the typical symptoms of an intense chest pain during a cardiac event. Instead, they experience subtler signs such as shortness of breath, sweating, fatigue, light-headedness, or reduced tolerance to physical activity. The disease also accelerates plaque buildup and causes multiple arteries to get blocked. Often smaller coronary arteries are also affected making diagnosis and treatment more complex. Owing to the silent progression of the disease in diabetic patients, CAD often goes undiagnosed until it reaches an advanced stage, which raises the risk of cardiac events.
That is why regular check-ups and heart screenings matter so much. Eating well, staying active, taking medicines as advised and controlling blood sugar, blood pressure and cholesterol can all slow it down. But when the arteries are badly or widely blocked, medicines alone may not be enough.
Treatments for diabetics with CAD complications?
Coronary artery bypass grafting—bypass surgery, or CABG—is often the most suitable option for diabetics. The surgeon uses healthy blood vessels from the chest, arm or leg to create new routes around the blocked arteries. Its main advantage is clearing several blockages in a single operation. Since diabetics usually have more than one blocked artery, this often means better long-term outcomes: longer survival, fewer heart attacks, fewer repeat procedures.
Why is angioplasty not suitable?
Angioplasty is a minimally invasive treatment in which a stent or a small metal mesh tube is inserted to keep the artery open. Although this procedure has a faster recovery time, the chances of requiring more interventions for complicated cases are higher. Typically, it is more suitable for a single artery blockage.
How can early diagnosis improve outcomes?
CAD progresses slowly in diabetics. By the time symptoms show up, significant damage may have already happened. Early screening can help detect the disease before it causes serious problems, allowing a range of treatment options to manage or prevent further complications. In many cases, identifying the condition early can be the difference between preventing a cardiac event and treating one after it has happened.
